Abstract
Abstract only
560
Background: Colorectal cancer (crc) is one of the most common cancers worldwide. There is an increasing incidence in low and middle income countries (LMICs). Patient outcomes are poor due to a lack of screening programs. Timely and efficient referral leading to earlier diagnosis of crc is imperative to improve survival. This study was initiated to determine the value of colonoscopy in patients with rectal bleeding for diagnosing crc in Nigeria. Methods: This is a prospective study of patients older than 45 years that present with rectal bleeding at 5 primary health care facilities in Ile-Ife, Nigeria. Patients were enrolled when they were referred for colonoscopy at the Endoscopy unit of Obafemi Awolowo University Teaching Hospitals. Data obtained included the socioeconomic, clinical, anthropometric, colonoscopy and histopathological parameters. Results: In this interim analysis, 68 patients were recruited into the study. The median age was 58.5 years (range 45-89 years). Median duration of rectal bleeding was 6 months (0.25 -360 months). Fifty six (82.4%) patients had seen a doctor regarding their rectal bleeding prior to the current episode for which they were referred. Changes in bowel habits and weight loss were found in 29 (42.6%) and 30 (44.1%) patients respectively. Crc was found in 14 (21%) patients and polyps in 11 (16.2%) patients. Hemorrhoids were found in 68% of patients. Of the 14 patients with crc, 10 had stage II or III disease (71.4%). Weight loss occurred in 14 (100%) of patients with crc, compared to 16 (30%) of patients without crc (p<0.0001). Conclusions: Given the high specificity of rectal bleeding in predicting the possibility of occurrence of colorectal cancer and polyps, this symptom may be used to select patients needing screening in resource poor settings. [Table: see text]